"There were times when I thought maybe I did not place because I didn't wear the wig," she said. "I wanted to be Miss Delaware more than anything in the world, and sometimes when you want a job that badly you need to take a step back and think, 'What [do] I need to do to make sure that I'm ready for this job?'"

Martell said she feels that people find her more approachable in public when wearing her wig. Otherwise, people tend to worry that she is ill.

Even so, she said, she loves the way she looks bald.

"The real Kayla is the Kayla underneath the wig," Martell said. "But the Kayla as Miss Delaware is comfortable both ways."

Kayla Martell: Bald Head, Bold Heart

While Martell may be comfortable as a bald woman, the standard of beauty for most people includes hair, which can transform our look.

"Hair is one of the most important things you see when you see someone, and you make a first impression, a lot, based on their hair," said Linda Wells, editor in chief of the beauty magazine Allure. "Psychologists have studied hair and its effect on self confidence, on self-esteem, and found that when women report they're having a bad hair day, they feel that they are not good at anything."

'I'm Not Sick -- Just Bald!'

This value placed on beautiful hair is something we feel even as children.

"Hair was always extremely important to me, as I think it is for most girls growing up," said Sheila Bridges, who also lives with alopecia areata.

Bridges, 46, said she loved having distinctive curly hair throughout her childhood and as an adult.

Bridges was a successful interior designer and host of her own cable television show when her hair began falling out six years ago.

"It was really a very difficult and traumatic experience," she said. "[I] had all these business commitments to my clients, for my design business and for television, and suddenly I was dealing with something that was very difficult and personal."

Photo credit: Sheila Bridges/Elle Decor.

Bridges said she initially donned hairpieces and wigs to continue her TV season because she got the impression people were concerned about her appearance.

"People were concerned about my contract not being renewed if I didn't have hair," she said. "So it was sort of hush, hush. People weren't supposed to know. I wasn't really supposed to tell people, which I think made it feel shameful."

Bridges wore the wigs, but she felt uncomfortable in them, comparing it to wearing a scratchy wool sweater on her head. She finished the TV season and the show was not picked up for another. When her show ended, she decided it was also the end of wearing wigs.

The change took some getting used to in the way people reacted to her.

"I felt very self conscious, very insecure. I was always sort of on guard," she said. "When you don't have hair, somehow the boundaries change and people feel as though they can say sort of whatever they want."

Bridges said that as with Martell many people assumed she was ill or receiving treatment for cancer. To set the record straight, Bridges decided to undergo a sort of unveiling, and she allowed herself to be photographed for design magazine Elle Decor.

"It's a design magazine and that's what I do for a living so for me it was an appropriate venue to sort of come out," she said.

Redefining Beauty

As she "came out" to her friends and clients about being one of the 5 million Americans affected by alopecia areata, Bridges came to redefine herself and what it means to be beautiful.

"There were no positive images in the media that told me that I was OK and to go outside and be bald," she said. "So it took a lot of time and sort of adjusting to find that definition for myself. My definition of beauty now is what I call the Four C's: confidence, it's courage, it's comfort and compassion."

The need to change the standard of beauty is something even a beauty queen understands.

"Beauty comes in all different kind of packages," Martell said. "You could be a beauty queen and not have hair."

Which begs the question, which Kayla Martell, with wig or without, will be showing up for the Miss America pageant in January?

"I've been so lucky that the Miss Delaware organization has told me, 'It's up to you, Kayla.' And I'm still making my decision at this point," she said.

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